基于流行病学调查报告对甘肃省食源性 疾病事件实验室证据及相关问题的分析

Laboratory evidence of foodborne disease events and related problems in Gansu based on epidemiological survey reports

目的 分析甘肃省食源性疾病事件中实验室检验对其结论的支持力度,以及影响实验室检出的部分因素,为提升甘肃省食源性疾病事件调查结论的质量提供依据。方法 收集2018-2020年甘肃省发病≥5例的食源性疾病事件的流行病学调查报告,对实验室检验或影响检出的有关信息进行整理,按照相关指南及标准的要求对结论进行评价。结果 共收集102起事件的流行病学调查报告,47起明确致病因子种类,但仅有15起(31.91%)事件中致病因子获得充分的实验室证据支持,其中化学性事件占83.33%,细菌性和植物性及毒蘑菇中毒事件分别占24.00%和25.00%;另外55起诊断为不明原因事件,分析认为疾病预防控制中心接报及时性对事件处置中样品的可获得性有影响,且该类事件仅有23.08%的检测项目选择恰当。结论 应重点加强细菌性、植物性及野蘑菇中毒事件处置中实验室检验工作,从加强事件调查中的采样工作和提高检测项目选择准确性两方面着手可降低不明原因事件比例。

Objective To evaluate the laboratory evidence support in the identification of foodborne disease events and related factors in Gansu province,and provide evidence for improving the quality of investigation results of food-borne disease events.Methods Epidemiological survey reports of food borne disease events involving more than 5 patients in Gansu from 2018 to 2020 were collected,and information about laboratory tests or related factors were analyzed,and the conclusions of the reports were evaluated according to the requirements of relevant guidelines and standards.Results A total of 102 survey reports of foodborne disease events were collected,of which 47 had clear etiological conclusions,but only 15(31.91%)had sufficient laboratory evidences.Chemical events accounted for 83.33%,and the proportions of bacterial and botanical or mushroom poisoning events were only 24.0%and 25.0%,respectively.The other 55 foodborne disease events were unexplained.The analysis suggested that the timely reporting to centers for disease control and prevention had an impact on the collection of samples in the event response,and only 23.08%of test items were appropriate.Conclusion It is necessary to strengthen the laboratory testing for bacterial and botanical or wild mushroom poisoning cases.The proportion of unexplained events can be reduced by improving the sample collection and detection item selection.